PMID- 25504156
OWN - NLM
STAT- MEDLINE
DCOM- 20160318
LR  - 20220317
IS  - 1865-8652 (Electronic)
IS  - 0741-238X (Print)
IS  - 0741-238X (Linking)
VI  - 31
IP  - 12
DP  - 2014 Dec
TI  - Retrospective analysis of long-term adherence to and persistence with DPP-4 
      inhibitors in US adults with type 2 diabetes mellitus.
PG  - 1287-305
LID - 10.1007/s12325-014-0171-3 [doi]
AB  - INTRODUCTION: Patients with type 2 diabetes mellitus (T2DM) must remain adherent 
      and persistent on antidiabetic medications to optimize clinical benefits. This 
      analysis compared adherence and persistence among adults initiating dipeptidyl 
      peptidase-4 inhibitors (DPP-4is), sulfonylureas (SUs), and thiazolidinediones 
      (TZDs) and between patients initiating saxagliptin or sitagliptin, two DPP-4is. 
      METHODS: This retrospective cohort study utilized the US MarketScan((R)) (Truven 
      Health Analytics, Ann Arbor, MI, USA) Commercial and Medicare Supplemental health 
      insurance claims databases. Adults aged >/=18 years with T2DM who initiated a 
      DPP-4i, SU, or TZD from January 1, 2009 to January 31, 2012 were included. 
      Patients must have been continuously enrolled for >/=1 year prior to and >/=1 year 
      following initiation. Adherence was measured using proportion of days covered 
      (PDC), with PDC >/= 0.80 considered adherent. Persistence was measured as time to 
      discontinuation, defined as last day with drug prior to a 60+ days gap in 
      therapy. Multivariable logistic regression and Cox proportional hazards models 
      compared the outcomes between cohorts, controlling for baseline differences. 
      RESULTS: The sample included 238,372 patients (61,399 DPP-4i, 134,961 SU, 42,012 
      TZD). During 1-year follow-up, 47.3% of DPP-4i initiators, 41.2% of SU 
      initiators, and 36.7% of TZD initiators were adherent. Adjusted odds of adherence 
      were significantly greater among DPP-4i initiators than SU (adjusted odds ratio 
      [AOR] = 1.678, P < 0.001) and TZD initiators (AOR = 1.605, P < 0.001). During 
      1-year follow-up, 55.0% of DPP-4i initiators, 47.8% of SU initiators, and 42.9% 
      of TZD initiators did not discontinue therapy. Adjusted hazards of 
      discontinuation were significantly greater for SU (adjusted hazard ratio 
      [AHR] = 1.390, P < 0.001) and TZD initiators (AHR = 1.402, P < 0.001) compared 
      with DPP-4i initiators. Saxagliptin initiators had significantly better adherence 
      (AOR = 1.213, P < 0.001) compared with sitagliptin initiators, and sitagliptin 
      initiators had significantly greater hazard of discontinuation (AHR = 1.159, 
      P < 0.001). Results were similar over a 2-year follow-up. CONCLUSIONS: US adults 
      with T2DM who initiated DPP-4i therapy, particularly saxagliptin, had 
      significantly better adherence and persistence compared with patients who 
      initiated SUs or TZDs.
FAU - Farr, Amanda M
AU  - Farr AM
AD  - Truven Health Analytics, 7700 Old Georgetown Road, 6th Floor, Bethesda, MD, 
      20814, USA, amanda.farr@truvenhealth.com.
FAU - Sheehan, John J
AU  - Sheehan JJ
FAU - Curkendall, Suellen M
AU  - Curkendall SM
FAU - Smith, David M
AU  - Smith DM
FAU - Johnston, Stephen S
AU  - Johnston SS
FAU - Kalsekar, Iftekhar
AU  - Kalsekar I
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20141212
PL  - United States
TA  - Adv Ther
JT  - Advances in therapy
JID - 8611864
RN  - 0 (Dipeptides)
RN  - 0 (Dipeptidyl-Peptidase IV Inhibitors)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Sulfonylurea Compounds)
RN  - 9GB927LAJW (saxagliptin)
RN  - PJY633525U (Adamantane)
RN  - TS63EW8X6F (Sitagliptin Phosphate)
MH  - Adamantane/*analogs & derivatives/therapeutic use
MH  - Adult
MH  - Aged
MH  - Cohort Studies
MH  - *Diabetes Mellitus, Type 2/drug therapy/epidemiology
MH  - Dipeptides/*therapeutic use
MH  - Dipeptidyl-Peptidase IV Inhibitors/therapeutic use
MH  - Female
MH  - Humans
MH  - Hypoglycemic Agents/therapeutic use
MH  - Logistic Models
MH  - Long-Term Care/statistics & numerical data
MH  - Male
MH  - Medicare/statistics & numerical data
MH  - Medication Adherence/*statistics & numerical data
MH  - Middle Aged
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Sitagliptin Phosphate/*therapeutic use
MH  - Sulfonylurea Compounds/*therapeutic use
MH  - United States/epidemiology
PMC - PMC4271133
EDAT- 2014/12/17 06:00
MHDA- 2016/03/19 06:00
PMCR- 2014/12/12
CRDT- 2014/12/16 06:00
PHST- 2014/10/23 00:00 [received]
PHST- 2014/12/16 06:00 [entrez]
PHST- 2014/12/17 06:00 [pubmed]
PHST- 2016/03/19 06:00 [medline]
PHST- 2014/12/12 00:00 [pmc-release]
AID - 171 [pii]
AID - 10.1007/s12325-014-0171-3 [doi]
PST - ppublish
SO  - Adv Ther. 2014 Dec;31(12):1287-305. doi: 10.1007/s12325-014-0171-3. Epub 2014 Dec 
      12.